Pediatric Eye Care

Your Child’s Exam And Common Eye Disorders

Children laying in the circle

A comprehensive pediatric eye exam can diagnose many different eye conditions. Some of the more common eye conditions in children are:

Your child may be nearsighted (myopia), farsighted (hyperopia) or have astigmatism. It is important that children who need glasses, wear them full time when they are young to develop good vision in each eye and three-dimensional vision.

If your child cannot identify alphabet letters because of age or development, here is a link to pictures that can be reviewed at home before the vision test at the eye doctor. Visit our optical shop to learn more about our selection of pediatric frames.

Amblyopia or “lazy eye” – Amblyopia occurs when the vision is reduced in one eye, causing it to be weaker than the other. This can occur because there is a difference in prescription between the 2 eyes and one eye becomes more dominant. Or, amblyopia can occur because of strabismus, or misaligned eyes. If an eye turns in or out, it does not see as clearly as the straight one and becomes weaker. Rarely, cataracts or severely droopy eyelids can cause amblyopia as well. The main treatment for amblyopia is patching the stronger, more dominant eye to allow the weaker eye a chance to gain vision. Dilating drops can also be used in some cases to blur the vision in the better eye, in essence working as a patch.

Strabismus or misaligned eyes – Eyes can cross in (esotropia), drift out (exotropia) or be higher or lower than the other (hypertropia or hypotropia). For specific kinds of strabismus, glasses are sufficient to straighten a child’s eyes, otherwise, eye muscle surgery is required.

Ocular abnormalities – Rarely, children can also develop cataracts, retinal or optic nerve problems, which can also decrease their vision.

During your child’s comprehensive eye exam, visual acuity will be tested. This test measures the smallest object each eye can see at a certain distance. Normally, each eye will be done individually by covering one eye at a time. It may be necessary to tape a patch over a child’s eye to keep him from peeking. The use of the Snellen chart is the most common way to test visual acuity. This chart has letters and numbers that decrease in size. When taking the test, the distance between the patient and the chart is 20 feet.

20/20 vision is normal. If a person has 20/40 vision, they see at twenty feet what a normal eye sees at forty feet. If a person has 20/200 vision, they are legally blind. They only see at twenty feet what a normal eye sees at two hundred feet. If they have 20/15 vision, they see better than normal. They see at twenty feet what the normal eye would have to bring in to fifteen feet to see.

For children that do not know letters and numbers, they can be tested with the Tumbling E chart or pictures. To take the Tumbling E test, the child points his/her finger in the same direction as the E is pointing. Children who are younger than four may have trouble with this test so there are several different tests used to obtain a child’s accurate visual acuity.

Other tests that will be done at your child’s exam are:

  • Check for indications of crossed eyes
  • Check to ensure the child is using both eyes
  • Tests to determine how well the child’s vision skills are developing
  • Tests to determine a normal color vision

Signs That Your Child May Need an Eye Exam:

  • Holding a book too close to their eyes.
  • Difficulty reading the blackboard in school.
  • Complaints of blurry eyesight.
  • Squinting a lot.
  • Closing or covering one eye in order to see.

If your child is experiencing any of these symptoms, schedule an appointment today at Raleigh Ophthalmology

What to Expect During my Child’s Eye Exam

Doctor giving child an eye examA typical pediatric comprehensive eye exam includes some procedures which may be unfamiliar. Parents may wish to review the following with their child in a positive way that can make the exam a pleasant experience. After checking vision with a wall chart, several measurements are taken which may include the use of:

  • A penlight
  • Eye cover/occludes
  • Fixation toys and video
  • Prism Bar
  • Silt Lamp
  • Phoropter
  • Lens trial frame
  • Ophthalmoscope

Eye drops are given to dilate the pupils to measure the child’s focus and retina. Since it takes time for the drops to take effect, there is a waiting period that contributes to a full exam sometimes lasting up to 1 ½ hour. A playroom is available while waiting with younger children.

Children’s Eye Safety

Each year thousands of children have eye injuries at home, at play or while on the road. 90% of these injuries are avoidable, Please take these simple steps to avoid eye injuries your children may encounter.

The most common causes of eye injuries to children include:

  • Misuse of toys
  • Falls from beds, against furniture, on stairs, and when playing with toys
  • Misuse of everyday tools and objects (work and garden tools, knives and forks, pens and pencils)
  • Contact with harmful household products (detergents, paints, glues, etc.)
  • Automobile accidents.

Finding the Hazards:

At Home:

  • Use safety gates at top and bottom of stairs
  • Pad or cushion sharp corners
  • Put locks on all cabinets and drawers that kids can reach
  • Keep all sharp or pointed objects out of kid’s hands
  • Put away all hazardous chemicals, including cleaning solutions
  • Keep your child out of work areas
  • Recognize that even common household items such as paper clips, bungee cords, wire coat hangers, rubber bands, and fishhooks can cause serious eye injury

At Play:

  • Read all warnings and instructions on toys. Avoid toys with sharp edges or hardpoints, spikes, and rods. Toys that fly or shoot are intended for older children and should be used with extreme care or not purchased all together
  • Be aware of items in playgrounds and play areas that are hazards. Make sure your child wears proper eye protection when playing sports
  • Fireworks and sparklers account for over 2000 eye injuries a year. The best protection is to leave the fireworks to the professionals and not to purchase sparklers for your children

On the Road:

  • Make sure children are properly secured in baby carriers and child safety seats and that the seat and shoulder belts fit well.
  • Children age 12 and younger should never ride in the front seat. Store loose items in the trunk, or secured on the floor.
  • Any loose object can become dangerous in a crash.

How to tell if your child has an eye injury:

  • Your child has obvious pain or trouble seeing
  • Your child has a cut or torn eyelid
  • One eye does not move as well as the other
  • One eye sticks out compared to the other
  • The eye has an unusual pupil size or shape
  • There is blood in the clear part of the eye
  • Your child has something in the eye or under the eyelid that can’t be easily removed

If you notice any of these signs, seek medical help right away.